Fake Medicines may Kill a Million a Year

Central and Eastern Europe is facing 'significant challenges' in combating a multi-billion euro, and often lethal, trade in fake medicines, security and pharmaceutical groups have warned.

The region has been identified as a key smuggling route in an illicit trade which is growing every year.

Millions of counterfeit tablets and medicines, some of them containing lethal heavy metals, are smuggled annually. The World Health Organisation (WHO) estimates that 50 percent of medicines sold online are fake.

But while some Eastern European states have brought in strict laws and procedures to fight fake medicine smugglers, criminals in the region are thought to be working with international gangs in neighbouring states to bring contraband medicines into the EU.

Gabriel Turcu, partner at the European anti-counterfeiting organisation REACT, told IPS: 'It has been shown that there are people in Central and Eastern European EU member states working with organised gangs in neighbouring countries to bring counterfeit medicines into the European Union and westwards. This is a significant challenge for the region.'

Just like the drug and people trafficking trade, the counterfeit medicine industry is estimated to be worth tens of billions of euros per year for crime gangs, and is mushrooming every year.

The United Nations Office on Drugs and Crime has estimated that this year the illegal market in counterfeit medicines will provide more than 75 billion euros in revenues for smugglers -- a rise of 92 percent on 2005.

Police forces say that fake medicines, sometimes so well-prepared and packaged that they can fool even healthcare professionals, are being shipped out by crooks in the same illegal consignments as narcotics. Gangs then sell them on to unscrupulous medicine wholesalers or direct to the public online.

Health experts estimate that fake medicines -- made from anything from crushed brick to arsenic -- cause up to one million deaths a year, and the UN has said they are contributing to growing drug resistance.

Kristian Bartholin, who is involved in drawing up a Council of Europe convention on counterfeit medicines, told IPS: 'This trade is potentially lethal and the situation in general is probably worse than we think because so much of the trade is carried out via the Internet. There are a lot of black areas involved where it is hard to get clear information.'

India and China are thought to be the main source countries for the fake medicines, but customs officers in central and Eastern Europe have said that they are being brought into Europe on the same smuggling routes used for narcotics and people -- through Eastern Europe and the Balkans.

A lack of resources combined with low wages leading to high levels of corruption among customs officers had in the past been identified as making borders in the region invitingly porous for crime gangs.

Although those borders have been ostensibly beefed up and better controlled following Eastern European countries' accession into the European Union in 2004 and 2007, there are still concerns that criminals could exploit weaknesses in local border controls.

Steve Allen, senior director of global security at the pharmaceutical giant Pfizer, told IPS: 'The countries (in Eastern Europe) have extensive land borders, and in general, have great freedom of movement between them, and other neighbouring states. These present challenges to customs and law enforcement in monitoring the movement of any goods.

'It's also worth remembering that the counterfeit issue is not just about 'smuggling' -- it's possible that counterfeits could be manufactured almost anywhere, including Eastern Europe.'

Pfizer issued a report earlier this year saying that the market in counterfeit medicines in Europe is worth an estimated 10.5 billion euros annually, with people in Italy and Germany spending the most on what later turn out to be fake medicines -- an estimated 3.6 billion and 2.7 billion euros respectively.

EU officials have said that in a two-month period last year 34 million fake tablets were seized by customs officials while the Council of Europe says that in some parts of Europe fake medicines make up between six and 20 percent of the market.

Public awareness of the risks of counterfeit medicines is also low, according to research.

Allen told IPS: 'One survey we conducted showed that one in five people in Western Europe were happy to purchase medicines without a prescription, and did not appreciate the potential dangers. We don't have specifics for the countries (in central and Eastern Europe) but we expect that awareness is pretty similar to what we have seen in other European countries.'

While punishments for drug running and people smuggling are severe and risks high, those for counterfeit medicines are generally far less. In some countries production and selling of counterfeit medicines is not considered a crime and in many Western states it was until relatively recently viewed legally as being on a par with trading in fake branded clothes.

'For a long time it was seen more as an economic crime, a matter of copyright infringement. That attitude is changing now and it is being realised for the very serious, and sometimes lethal, crime that it is and hence many countries are now changing their legislation,' said Bartholin.

Eastern European states have begun to implement stricter penalties for convicted medicine smugglers -- in Romania for instance, prison sentences have been handed down to some smugglers this year. But health experts, pharmaceutical producers and international organisations want clear laws introduced reflecting the severity of the illegal trade.

Turcu, who last week attended a special conference in Bucharest which brought together country representatives and law enforcement officials from across the region to discuss the threat of counterfeit medicines, told IPS: 'What is needed is a directive from the EU making it mandatory for countries at national level to qualify counterfeiting as a crime and counterfeiting that harms people as a serious crime.'